胎膜早破与孕妇阴道微生态及血清IL-10、IL-22、NF-κB的相关性

Correlation between premature rupture of membranes and vaginal microecology and serum levels of IL-10, IL-22 and NF-κB in pregnant women

目的探讨胎膜早破与孕妇阴道微生态及血清IL-10、IL-22、NF-κB的相关性。方法选取我院妇产科收治的84例胎膜早破孕妇为胎膜早破组,100例正常孕妇为正常孕妇组及100例正常未怀孕妇女为正常妇女组。比较3组对象阴道分泌物各细菌阳性率、阴道微生态状态及各组间血清IL-10、IL-22、NF-κB水平。对胎膜早破孕妇阴道微生态失衡与血清IL-10、IL-22、NF-κB水平进行Pearson相关性分析。结果胎膜早破组孕妇阴道乳杆菌(79.8%)、大肠埃希菌(48.8%)、溶血葡萄球菌(22.6%)检出率均显著高于正常孕妇组和正常妇女组(均P<0.05)。胎膜早破组患者阴道pH(6.87±0.75)、阴道微生态失衡率(40.5%)均显著高于正常孕妇组和正常妇女组,H2O2阳性率(11.9%)低于正常孕妇组(21.0%)和正常妇女组(23.0%),差异均有统计学意义(均P<0.05)。胎膜早破组孕妇血清IL-10、IL-22、NF-κB水平[(51.28±6.58)pg/mL、(45.91±7.13)pg/mL、(30.47±3.27)ng/mL]均显著高于正常孕妇组和正常妇女组。经过Pearson相关性分析,IL-10、IL-22、NF-κB水平与胎膜早破孕妇阴道微生态失衡呈正相关(r=0.657、0.692、0.732,P<0.05)。结论孕妇阴道微生态环境发生改变引起阴道菌群失调及血清免疫因子的变化,可能是引发胎膜早破的作用机制之一。

Objective To investigate the relationship between premature rupture of membranes and vaginal microecology and serum levels of IL-10, IL-22 and NF-κB in pregnant women. Methods A total of 84 cases of premature rupture of membranes, 100 cases of normal pregnancy and 100 normal non-pregnant women were included. The positive rate of bacteria in vaginal secretions, vaginal microecological status and serum levels of IL-10, IL-22 and NF-κB were compared among the three groups with pearson correlation analysis. Results The positive rates of Lactobacilli(79.8%), Escherichia coli(48.8%) and Staphylococcus haemolyticus(22.6%) in premature rupture group were significantly higher than those in normal pregnancy group and normal non-pregnancy group(all P<0.05). Compared with normal pregnancy group and normal non-pregnancy group, the vaginal pH(6.87±0.75) and vaginal microecological imbalance rate(40.5%) in premature rupture group were significantly higher, whereas the positive rate of H2O2 was lower(11.9% vs 21.0% vs 23.0%). The serum levels of IL-10(51.28±6.58) pg/mL, IL-22(45.91±7.13) pg/mL and NF-κB(30.47±3.27) ng/mL in premature rupture group were significantly higher than those in normal pregnancy group and normal non-pregnancy group, respectively. Pearson correlation analysis showed that IL-10, IL-22 and NF-κB were positively correlated with vaginal microecological imbalance in pregnant women with premature rupture of membranes(r=0.657, 0.692, 0.732, P<0.05). Conclusion The change of vaginal microecological environment in pregnant women can cause the imbalance of vaginal flora and the change of serum immune factors, which may be one of the mechanisms of premature rupture of membranes.